Double-blind, randomized, placebo-controlled study of a lotion containing triethyl citrate and ethyl linoleate in the treatment of acne vulgaris

Background Acne vulgaris is a major clinical problem; despite a vast array of treatment modalities available for acne, there is considerable dissatisfaction in acne treatment among patients and doctors. Rising antibiotic drug resistance consequent to the widespread use of topical antibiotics is causing concern and effective nonantibiotic treatments are needed. Objectives To evaluate the efficacy and tolerability of a novel lotion containing triethyl citrate and ethyl linoleate in the treatment of mild to moderate acne vulgaris. Methods This was a double- blind, placebo- controlled, randomized study comparing the active lotion containing triethyl citrate and ethyl linoleate with its vehicle as a placebo control. Patients were assessed by the modified Leeds acne grading system as well as by counting inflammatory and noninflammatory lesions on the face at weeks 0, 4, 8 and 12. Sebum production was assessed by the Sebutape method at weeks 0 and 12. All adverse events were recorded. Results Forty patients were recruited into the study, of whom 33 completed the study. Active treatment was statistically superior to placebo in reduction of Leeds grading and total, inflammatory and noninflammatory lesion counts. The active lotion showed a rapid response with obvious reduction in lesion counts and acne grading by 4 weeks. Sebum production was significantly reduced in the actively treated group, with a mean reduction of 53% in sebum production compared with baseline. One patient developed irritation to the active lotion and withdrew from the study. Conclusions The new lotion containing triethyl citrate and ethyl linoleate has been shown to be an effective treatment for mild to moderate acne, with an effect on both inflammatory and noninflammatory acne lesions. The new lotion worked quickly and was generally well tolerated. A surprising finding was the significant impact the new lotion has on sebum production, suggesting a role in patients with seborrhoea. This nonantibiotic preparation will be a very useful addition to existing treatments for acne.